Individual
MR. BLAKE WILLIAM BADILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
488 SAINT LUKES DR, MONTGOMERY, AL 36117-7104
(334) 288-7808
Mailing address
201 DEFENSE HWY STE 205, ANNAPOLIS, MD 21401-7096
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3-002374
AL
Other
Enumeration date
06/02/2025
Last updated
09/22/2025
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